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Haley, K. L., Womack, J. L., Harmon, T. G., McCulloch, K. L. & Richard A., F. (2019). Life activity choices by people with aphasia: repeated interviews and proxy agreement. Aphasiology, 33(6), 710-730
Open this publication in new window or tab >>Life activity choices by people with aphasia: repeated interviews and proxy agreement
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2019 (English)In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 33, no 6, p. 710-730Article in journal (Refereed) Published
Abstract [en]

Background: Person-centered rehabilitation requires that meaningful life activities are identified on a case-by-case basis, but the discovery process can be inaccessible for clients with aphasia. Card-sorting methodology addresses core barriers and help clients communicate their preferences.

Aims: To characterize life activities that people with aphasia want to do, to estimate consistency in selections over time, and to replicate previous findings about the ability of family members and friends to identify their loved ones’ activity preferences.

Methods & Procedures:  We administered the Life Interests and Values (LIV) Cards to 26 people with aphasia, asking them which of 95 depicted life activities they wanted to do more in their lives. Half the activity cards were presented again one to ten weeks later. Twenty family members or friends responded as proxies by selecting from a questionnaire with the same items.

Outcomes & Results: Participants with aphasia selected diverse activities, though as a group they identified significantly more activities from the “social” activity category than from the “home and community”, “creative and relaxing”, or “physical” categories. Across the repeated interviews, they selected identical activities on average 78% of the time. Item-to-item agreement between people with aphasia and their proxy responders was significantly lower at 69%.

Conclusions: People with aphasia have diverse activity interests and are reliable informants about their preferences. Because significant others have limited ability to predict these choices, their impressions are inadequate substitutes for direct interviews.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-70535 (URN)10.1080/02687038.2018.1506087 (DOI)000466534500005 ()2-s2.0-85051939733 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-04-12 (johcin)

Available from: 2018-08-22 Created: 2018-08-22 Last updated: 2019-05-15Bibliographically approved
Womack, J. L., Lilja, M., Dickie, V. & Isaksson, G. (2019). Occupational Therapists’ Interactions With Older Adult Caregivers: Negotiating Priorities and Expertise. OTJR (Thorofare, N.J.), 39(1), 48-55
Open this publication in new window or tab >>Occupational Therapists’ Interactions With Older Adult Caregivers: Negotiating Priorities and Expertise
2019 (English)In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 39, no 1, p. 48-55Article in journal (Refereed) Published
Abstract [en]

Although numerous studies have examined provider–caregiver interactions and their influence on care outcomes, few represent the perspective of the provider or specifically consider occupational therapy practitioners. The aim of this article is to explore the perspectives of occupational therapists regarding interactions with older adult caregivers in geriatric practice settings. The study was conducted using a constructivist grounded theory approach based on data obtained from repeated focus group sessions and subsequent individual reflections. Occupational therapy practitioners interact with older adult caregivers in ways that reflect negotiations about who holds expertise and whose priorities are most relevant in care situations. These interactions are influenced by health care contexts that foreground the needs of the care recipient. A deeper understanding of caregiving as an occupation via a transactional perspective may serve to illuminate complex care situations and optimize therapist–caregiver interactions.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
caregivers, occupational therapy, older adults, grounded theory
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-70866 (URN)10.1177/1539449218799445 (DOI)000453436100007 ()30205761 (PubMedID)2-s2.0-85058532664 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-01-08 (johcin)

Available from: 2018-09-14 Created: 2018-09-14 Last updated: 2019-04-17Bibliographically approved
Womack, J. L. (2018). The Occupation of Caregiving: Moving Beyond Individualistic Perspectives. (Doctoral dissertation). Luleå: Luleå University of Technology
Open this publication in new window or tab >>The Occupation of Caregiving: Moving Beyond Individualistic Perspectives
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Omsorg om andra som aktivitet : mer än ettindividualistiskt perspektiv
Abstract [en]

The overall aim of this research was to illuminate and describe caregiving as an occupation, informed by perspectives from older adult care partners and occupational therapists. An additional aim was to integrate and inform study findings with theoretical constructs that inform occupational therapy practice through occupational science and public health perspectives. Although caregiving was the main construct under consideration, the specific focus was on care situations involving older adults.

Study 1 considered the narratives of 3 older adult women serving as informal (unpaid) caregivers to friends and family members. All of the women were over the age of 65 and of varied racial/ethnic backgrounds. Data were elicited through story prompts embedded in repeated semi-structured interviews and analyzed using a storyboarding approach and poetic transcription.

Study 2 was an ethnographic case study considering how care dyads take part in community mobility, a common instrumental activity of daily living, with a particular focus on how the caregiver supports the participation of the care recipient. 3 care dyads (6 participants) over the age of 65 were consented into the study. The researcher employed participant observation, field note journaling and semi-structured interviews followed by thematic qualitative analysis to illuminate strategies used by these care dyads to remain active in community mobility in the context of their care situation.

Study 3 used a constructivist grounded theory approach to explore the perspectives of occupational therapists regarding their interactions with older adult caregivers. Repetitive focus groups with 11 occupational therapy practitioners, researcher memos and individual reflections from 2 additional participants provided multifaceted data that the researchers analyzed through several levels of coding to construct a grounded theory of occupational therapist-caregiver interactions.

Study 4 consisted of secondary data analyses of a national survey of adult caregivers conducted in the United States in 2014-2015. Data specific to 482 caregivers age 65+ and older and their care recipients were extracted from the overall sample and considered in relationship to responses to questions regarding support received from healthcare providers. Descriptive and inferential statistical analyses were employed to develop a profile of older adult care situations and predict inquiries of support from healthcare providers based on care situation characteristics.

Findings from the first two studies highlighted the relational nature of caregiving and an expanded view of the caregiver role. Study 1 also revealed that interactions with health care providers in positions of authority are often challenging and compel caregivers to act in ways they perceive as risky. Study 2 reinforced that caregivers act in ways that are influenced as much or more by the history of their relationships as by caregiving demands, and led to the explication of relational versus individual perspectives. These findings influenced the approaches used in studies 3 and 4, which focused on interactions between healthcare providers and older caregivers, specifically occupational therapists in study 3 and other healthcare professionals in study 4. Findings from study 3 resulted in a theoretical stance that occupational therapists are influenced by biomedical contexts to situate caregivers as paraprofessionals to help meet care recipient goals. This perpetuates an individualistic lens on caregiving, emphasizing the biomedical priorities of the patient over the priorities or support needs of the care situation. Support offered by healthcare providers in the form of inquiries about the needs of older caregivers was found in study 4 to be less than optimal, and appears not to be predicted by any characteristics of the care situation other than the living situation of the care recipient. In sum, individualistic perspectives fail to realize the occupational complexity of caregiving, and provide an opportunity to explore more collective paradigms when supporting older adult care situations.

 

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2018
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
Keywords
caregiving, occupational therapy, occupation, aging, individualism, socio-ecological perspective, transactional perspective
National Category
Occupational Therapy Health Sciences
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-68563 (URN)978-91-7790-136-5 (ISBN)978-91-7790-137-2 (ISBN)
Public defence
2018-06-15, D770, Luleå, 09:00 (English)
Opponent
Supervisors
Available from: 2018-05-02 Created: 2018-05-01 Last updated: 2018-06-08Bibliographically approved
Womack, J. L., Lilja, M. & Isaksson, G. (2017). Crossing a Line: A narrative of risk-taking by older women serving as caregivers. Journal of Aging Studies, 41, 60-66
Open this publication in new window or tab >>Crossing a Line: A narrative of risk-taking by older women serving as caregivers
2017 (English)In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 41, p. 60-66Article in journal (Refereed) Published
Abstract [en]

Background

Caregiving carried out by adults for other adults is increasing around the world as the demographics of many industrialized countries shift toward an older population with escalating care needs toward the end of life. Although much has been written about caregiving, few studies document the experiences of providing care as narrated by the caregivers.

Aim

To explore the everyday experiences of older adults serving as primary informal caregivers to significant others.

Methods

A process of narrative inquiry was used via repeated interviews with three older women caregivers providing care to family members or friends. The data were analyzed using storyboarding techniques and identifying critical turning points, culminating in a poetic transcription of the resulting narrative.

Results

These caregivers describe a tension that exists across their experiences and communication with authorities on whom they rely for guidance and collaboration. Situations in which this tension pushes the caregivers to act in ways that represent risk to themselves or their care recipients are central to the collective narrative.

Conclusion and significance

The everyday experiences of older adult caregivers include not only familiar care routines, but also advocacy on behalf of care recipients and negotiations with external authorities, resulting at times in unwelcome risk-taking. Their narrative warrants attention due to the lack of power described by caregivers when acting on behalf of their care recipients and the need for those in authority to recognize their dilemma.

Place, publisher, year, edition, pages
Elsevier, 2017
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-63134 (URN)10.1016/j.jaging.2017.04.002 (DOI)000404490400008 ()28610756 (PubMedID)2-s2.0-85018485234 (Scopus ID)
Note

Validerad; 2017; Nivå 2; 2017-04-24 (andbra)

Available from: 2017-04-24 Created: 2017-04-24 Last updated: 2018-07-10Bibliographically approved
Womack, J. L., Isaksson, G. & Lilja, M. (2016). Care partner dyad strategies to support participation in community mobility (ed.). Scandinavian Journal of Occupational Therapy, 23(3), 220-229
Open this publication in new window or tab >>Care partner dyad strategies to support participation in community mobility
2016 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 3, p. 220-229Article in journal (Refereed) Published
Abstract [en]

Background Factors supporting continued community mobility for older adults warrant attention due to the relationship between mobility, health, and social participation. Although community mobility is typically considered from the perspective of individual functional abilities, care partnerships represent a situation in which maintaining community mobility has implications for the well-being of all members. Aim The aim of this research was to explore and describe strategies used by older adult care partner dyads to support and maintain participation in community mobility. Methods Ethnographic case studies of three care partner dyads were conducted using in-depth interviews, participant observation, photographs, and reciprocal data analysis. An inductive, constant comparative data analysis resulted in thematic descriptions of strategies employed by the care partner dyads. Results Three strategies were identified in collaboration with care partners: (i) Acting in accordance with the values of the relationship, (ii) Finding and using available assistive technology and (iii) Relying on social networks. Conclusion and significance Strategies identified by participants were more relational than procedural in nature, indicating the need for occupational therapists working with care partner dyads to consider historical routines, social connectedness, and needs of the care partnership in addition to functional abilities of the care recipient when addressing community mobility

National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-3479 (URN)10.3109/11038128.2015.1126349 (DOI)000374634100005 ()26757979 (PubMedID)2-s2.0-84954211897 (Scopus ID)14eda54d-19f0-453f-9038-4704a19683e2 (Local ID)14eda54d-19f0-453f-9038-4704a19683e2 (Archive number)14eda54d-19f0-453f-9038-4704a19683e2 (OAI)
Note

Validerad; 2016; Nivå 2; 20160118 (andbra)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-07-10Bibliographically approved
Isaksson, G., Lilja, M., Carabante, J. R. & Womack, J. L. (2016). Challenges in occupational therapy when providing home-based rehabilitation for senior citizens (ed.). In: (Ed.), 1st CONTEC-ENOTHE Congress: National University of Ireland, Galway 15-19 June 2016. Paper presented at COTEC-ENOTHE Congress 2016 : 15/06/2016 - 19/06/2016 (pp. 325).
Open this publication in new window or tab >>Challenges in occupational therapy when providing home-based rehabilitation for senior citizens
2016 (English)In: 1st CONTEC-ENOTHE Congress: National University of Ireland, Galway 15-19 June 2016, 2016, p. 325-Conference paper (Refereed)
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-32916 (URN)792832b9-b2ff-4a52-8cf4-97e9fbbd2b33 (Local ID)792832b9-b2ff-4a52-8cf4-97e9fbbd2b33 (Archive number)792832b9-b2ff-4a52-8cf4-97e9fbbd2b33 (OAI)
Conference
COTEC-ENOTHE Congress 2016 : 15/06/2016 - 19/06/2016
Note

Godkänd; 2016; 20160629 (andbra)

Available from: 2016-09-30 Created: 2016-09-30 Last updated: 2018-05-18Bibliographically approved
Womack, J. L. (2016). Home-based activity support for dementia care partners (ed.). In: (Ed.), 1st CONTEC-ENOTHE Congress: National University of Ireland, Galway 15-19 June 2016. Paper presented at COTEC-ENOTHE Congress 2016 : 15/06/2016 - 19/06/2016 (pp. 449).
Open this publication in new window or tab >>Home-based activity support for dementia care partners
2016 (English)In: 1st CONTEC-ENOTHE Congress: National University of Ireland, Galway 15-19 June 2016, 2016, p. 449-Conference paper, Oral presentation with published abstract (Refereed)
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-39545 (URN)e5a63a57-1db2-48b8-9d41-f6fd9cc3fe5d (Local ID)e5a63a57-1db2-48b8-9d41-f6fd9cc3fe5d (Archive number)e5a63a57-1db2-48b8-9d41-f6fd9cc3fe5d (OAI)
Conference
COTEC-ENOTHE Congress 2016 : 15/06/2016 - 19/06/2016
Note

Upprättat; 2016; 20160630 (andbra)

Available from: 2016-10-03 Created: 2016-10-03 Last updated: 2018-05-18Bibliographically approved
Bagatell, N. & Womack, J. L. (2016). Human capacity for action as core content in occupational scienceeducation. Journal of Occupational Science, 23(4), 514-518
Open this publication in new window or tab >>Human capacity for action as core content in occupational scienceeducation
2016 (English)In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 23, no 4, p. 514-518Article in journal (Refereed) Published
Abstract [en]

Incentives for teaching occupational science may vary from advancementof the discipline to providing philosophical grounding for the profession ofoccupational therapy. Regardless of the aim, the essential content of thesubject matter – occupational science – has been largely unexplored. Inseeking to refine concepts of occupation that emerged from scholarshipin occupational therapy and yet distance the conversation from anapplied perspective, occupational scientists have focused heavily on theform, function and meaning of occupation as well as socioculturalfactors effecting occupational engagement. This focus has largelydivorced the content from the exploration of the embodied experienceof and the human capacity for action. This paper seeks to challenge thatdivision by considering human capacity for action as integral tounderstanding occupation, and knowledge of body structure andfunction as key to understanding human capacity for action. We offer anexample of a course where human capacity for action is foregrounded,enabling students to more clearly understand the relationship betweenoccupation, embodied action, and body structures and functions.

National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:ltu:diva-59908 (URN)10.1080/14427591.2016.1226682 (DOI)000387699700012 ()2-s2.0-84991396640 (Scopus ID)
Note

Validerad; 2016; Nivå 1; 2016-10-24 (andbra)

Available from: 2016-10-24 Created: 2016-10-24 Last updated: 2018-07-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2241-3303

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